Prototype

Eight

She tried to banish the word from her mind. Such an ugly word, rife with connotations unfair to a victim of biology’s whims and nature’s passion for variety. Still, the word lingered, applicable, technically correct.

Mutation.

No wonder she had detected such a thrill in the voice of the geneticist who had called with the news. He had been looking at something so unusual its implications weren’t even understood.

That weekend, Adrienne spent every free moment poring over genetics texts to give her at least some working knowledge of the subject, conversational footing in a science where even most M.D.’s were lacking. She burned both midnight and noonday oil, barely needing sleep. Sarah did not resent this in and of itself, only that for once Adrienne refused to share that which was consuming her. Tough. Sarah miffed was only a temporary condition, and this business of chromosomal mutation was just a bit beyond the usual pale of lives gone astray.

The core of the human animal, Adrienne knew, was written out in a seemingly endless sequence of protein codes, three billion base pairs in all, linked into the twining dual strands of a double helix, one of nature’s most elegant structures. Three billion links in the chain of DNA, an identical text found in the nucleus of nearly every cell in the body. She found mind-boggling the sheer numbers and the infinitesimal scale on which they existed. Scaled- up analogies were the only thing that helped her grasp the enormity of the miracle. One she found especially vivid: It was as if a rope with a diameter of two inches and a length of 32,000 miles was neatly arranged within an organic vessel the size of a domed stadium. Behold, a single nucleus.

The rope, however, was not of continuous length. Human DNA was apportioned among forty-six chromosomes, two of which, the X and the Y, determined gender, the remainder existing in twenty-two matched pairs. Every trait of structure and function and bearing that characterized one as a human being — as well as an individual among the world’s billions — was encoded in the 50- to 100,000 genes found along the chromosomes. Most of the time, when anything went wrong on a genetic level, what and where was a mystery, although the number of genes associated with specific diseases and defects was increasing all the time.

Of genetic disorders, she learned there were around 3500. Among those, a mere twelve were so obvious they could be sighted off a karyotype at a glance.

Among them were conditions such as Klinefelter’s syndrome and Turner’s syndrome and others afflicting normal gender designation. Too many X chromosomes, or not enough. Then there was the XYY male genotype that had provoked such hotly contested debate.

Down’s syndrome was also among this dozen, whose mentally retarded and physically impaired progeny carried a third copy of chromosome twenty-one, instead of the normal pair.

Twelve abnormalities, all unique.

But then there was Clay Palmer, who exhibited a thirteenth not even in any book she consulted: a triple set of chromosome twelve.

This was most unexpected.

And very, very new.

“How does this manifest itself in my patient?” she had asked.

“That’s the wrong question. It’s premature,” she was told by a geneticist named Ryker. “Inasmuch as I can’t even tell you what this means.”

In the physical nature of the defect, it was most obviously closest to Down’s syndrome, an identical glitch but involving a different pair of chromosomes. Clearly, Clay Palmer exhibited none of the symptoms characteristic of Down’s. He was highly intelligent, physically healthy, with no skull deformation or slanted eyes, no indication of heart disorder.

Chromosome twelve. Here too were located genes associated with hemolytic anemia, lipoma, myxoid liposarcoma, type-one vitamin D dependency, and —

Acute alcohol intolerance.

This could be a find. Clay had been hospitalized more than once for alcohol poisoning.

Her weekend was lost in a density of specialization and the vast interior landscape, never without a book, reading wherever opportunity presented itself: kitchen, office, bathroom, behind the wheel while stopped at traffic lights, on the sofa while failing to realize that for the past ten minutes Sarah’s feet had been in her lap. In learning there was safety, for to set the books aside was to remove the diversion and nakedly confront the fact that she was absolutely petrified.

Because what does it mean? What does this mean in terms of his body and his mind?

In her hospital sat a young man who by turns sought to tear himself and other people to pieces, the worst of his impulses held in check by a fragile grasp on the hope that he might learn to become something better. Whether a noble quest or a fool’s errand, Clay Palmer had seemingly yet to decide, but the outcome was largely up to her. If she was correct, Clay might only be months away from committing the ultimate irrevocable crime, after which intervention would become a moot point. His future would consist of prison, or death.

He had looked to her for help. And she was going to have to look him in the eye and tell him the truth, along with the words she hated most of all:

I’m sorry… I don’t know.

* * *

And how inadequate these words sounded to her ears. Who, though, among healers of body and mind, felt adequately trained in dealing out disappointment? Who felt comfortable admitting there were syndromes beyond their expertise, beyond even their knowledge? What pompous pretenders they all were at times. Their understanding of the totality of human life was barbarously crude, not far beyond using leeches and trephining holes into the skull to release evil spirits.

When Clay looked at her, it was with the same lost melancholy another’s face might have worn after being told a parent had died, or a sibling, a favorite grandparent… someone who had always been there, now gone. It was the face of downward spirals, and Adrienne pictured Clay sliding helplessly along a coil of double helix.

Thirty-two thousand miles. He might never hit bottom.

“It’s me, then.” His whisper was as soft as the sound of a knife on a throat.

His room felt cold for no good reason, or was she the only one who noticed? It was Monday afternoon, hell of a way to start the week — you seem to be coming along nicely in our sessions, and by the way, did you know you’re a freak of nature?

“I thought it was something I could work on, try to beat,” he said, “but it’s me…”

“Clay, please listen, there’s no reason to believe that. It’s too early to conclude what effect this might have on you, or even if it has one at all.”

“It’s me, it’s me,” and his voice curled into a low chant of loathing, “it’s me,” weighted forearms beginning to clash against each other, the casts striking as hammer and anvil, each blow harder than the last. Eyes wide, an acute madness brought on by knowledge — he had looked into deformity and found himself staring back. Black hair in tangles that fell into his eyes, he burned upon a pyre of his own fears, and she had no way to assuage them.

“It’s me and it’s in every fucking cell in my body!” Clay screamed.

He was off the bed before she realized what he was doing, lurching across the room to the far wall, throwing himself whole-bodied into a murderous swing at the chain link over the window. The cast — his right — rebounded with an atonal twang of metal, and he battered away at it again as she went for the door, holding it open, nodding into the hall while in they came, the enforcers of the asylum she’d had waiting just in case. He was code blue all over again, and succeeded in impacting the chain link with enough force to drive it into the window behind. Glass shattered, but if he wanted shards he was out of luck, nothing had fallen inside, so he sagged down the wall while turning on himself. Reddened fingertips hooked just beyond the ends of the casts, ragged nails in need of trimming. Clay seemed to regard his body as something hideous beyond tolerance, head straining on neck as if to distance itself from torso. With those heavy, clawed hands he ripped at the T-shirt under his robe, shredded through to the